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David G. Munoz, MD; Shirish M. Hastak, MD; Byrne Harper, MD; Donald Lee, MD; Vladimir C. Hachinski, MD

Arch Neurol. 1993;50(5):492-497.

Abstract
• The pathologic correlates of increased signal in the white matter of the centrum ovale in postmortem magnetic resonance imaging were investigated in an unselected series of 15 autopsies. Two types of magnetic resonance imaging hyperintensities could be separated on the basis of size (10-mm cutoff): extensive and punctate. The pathologic basis of extensive hyperintensities was large areas of pallor with ill-defined margins, located in the central white matter and sparing the subcortical U fibers on both myelin and axonal stains. Microscopically, these areas showed diffuse vacuolation and significant reduction in the areal densities of glial cells. This change was never seen in areas that did not show extensive white matter hyperdensities on magnetic resonance imaging. The correlates of punctate magnetic resonance imaging hyperintensities were less well defined; dilated Virchow-Robin spaces probably represent a common cause of this phenomenon.

Author Affiliations
From the the Departments of Clinical Neurological Sciences (Drs Munoz, Hastak, Harper, Lee, and Hachinski), Pathology (Dr Munoz), and Diagnostic Radiology (Dr Lee), University of Western Ontario, and the John P. Robarts Research Institute (Drs Munoz, Hastak, and Hachinski), London, Ontario.

Footnotes
Accepted for publication September 21, 1992.

Reprint requests to Department of Pathology, Dental Sciences Building, University of Western Ontario, London, Ontario, Canada N6A 5C1 (Dr Munoz).

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